Health care in Canada: patterns of funding and regulation

During the 1970s the share of health care expenditure in Canadian GNP remained roughly stable, in the range of 7-71/2 percent of GNP, in marked contrast to its escalation in most other countries (the U.S. in particular) and to previous Canadian experience. The shift to a stable pattern coincided with the completion of the Canadian system of universal comprehensive public hospital and medical care insurance. This paper explores how and why the public insurance system served to contain cost escalation. It then discusses the inadequacy of expenditure experience per se as a basis for health system evaluation--the same data will support claims of both "underfunding" and "spiralling costs." More serious questions involve the influence of alternative patterns of health care funding and delivery on the effectiveness and efficiency of care provision, and the resulting distributional patterns of care and income. A brief sketch is given of the present situation and future possibilities of Canadian health care under these heads.     

Attitudes of Canadians toward affirmative action: Opposition,value pluralism,and nonattitudes

Set against a backdrop of current public policy and case law, this study investigates Canadian attitudes toward affirmative action among both citizens and decision makers. We find low levels of support for such programs across a variety of contexts and intended beneficiaries, but we also discover that opinion on both sides of the issue is rather soft, for large portions of those taking positions on the matter are willing to reconsider their views when prompted. We interpret this finding as an indication of what Philip Converse has called nonattitudes. Thus, a substantial portion of Canadians appear to hold no genuine attitudes on the question of affirmative action and are relatively open to persuasion. In contrast, the preferences of those with stable attitudes are rooted in the tradeoff between values of equality and merit. Implications for policy activists in this issue area are discussed.The research reported here is part of a large project supported by the Social Sciences and Humanities Research Council (Grant No. 411-85-001). The Centre of Criminology at the University of Toronto has provided a home, and indispensable support, for the Charter Project. This research was also facilitated by a contribution from the Solicitor General of Canada to the Centre of Criminology, University of Toronto. Our thanks also go to Robert Vipond for his help in clarifying our concepts.     

Book reviews

Journal of Chinese Political Science -     

Candidates' Ideological Locations,Abstention, and Turnout in U.S. Midterm Senate Elections

Many spatial models of voting suggest that citizens are more likely to abstain when they feel indifferent toward the candidates or alienated from them. In presidential elections, previous research offers evidence that alienation and indifference affect individuals' probabilities of voting. We find evidence that indifference and alienation also affect the decision to vote in midterm Senate elections, a context not previously explored. These individual-level effects imply that candidates' ideological locations should influence aggregate turnout by affecting the proportions of citizens who feel indifferent toward or alienated from the candidates. Our aggregate-level analysis supports this (at least in contests featuring two previous and/or future members of Congress). Our findings underscore the importance of the electoral context for understanding citizen behavior and suggest that elections featuring at least one centrist candidate may be normatively appealing since they stimulate participation.